How to Record an EKG on Apple Watch: Easy Guide

To record an EKG on Apple Watch, open the ECG app and rest your finger on the Digital Crown for 30 seconds while keeping your wrist still.

The Apple Watch Series 4 and newer models can capture single-lead electrocardiogram readings that help track your heart rhythm patterns.

Table of Contents

What You Need Before Starting

Your Apple Watch needs to be Series 4 or newer to record EKGs. I found that older models simply don’t have the electrical sensors needed for heart rhythm monitoring.

You’ll also need to set up the ECG app first. This means updating your iPhone to iOS 12.2 or later and your watch to watchOS 5.2 or higher.

Compatible Apple Watch Models

Here are the models that can record EKGs:

Apple Watch Series 4
Apple Watch Series 5
Apple Watch Series 6
Apple Watch Series 7
Apple Watch Series 8
Apple Watch Series 9
Apple Watch Ultra
Apple Watch Ultra 2

Age and Location Requirements

The ECG feature only works if you’re 22 years or older. Apple built this limitation into the app based on FDA guidelines.

You also need to be in a supported country. The feature works in the United States, most of Europe, and several other regions where medical regulators have approved it.

Setting Up the ECG App

Before you can record your first EKG, you need to configure the app through your iPhone’s Health app.

Initial Setup Steps

Open the Health app on your iPhone and look for the ECG option. You’ll see a setup screen that walks you through the process.

The app asks for your birth date to confirm you’re over 22. It also shows you some important health information about what EKGs can and can’t detect.

Reading the Health Warnings

Apple includes several screens about medical limitations. The ECG app can’t detect heart attacks, blood clots, or strokes. It only checks for atrial fibrillation patterns.

This isn’t meant to replace visits to your doctor. Think of it more like a basic screening tool that might catch irregular rhythms.

Completing the Setup

After reading through the health info, tap “Set Up ECG” to finish the process. The ECG app should now appear on your Apple Watch.

How to Take Your First EKG Reading

Now comes the actual recording process. It’s pretty straightforward once you know the right technique.

Finding the ECG App

Look for a red heart icon with white lines on your watch face or in the app grid. The app might be tucked away in a folder if you have lots of apps installed.

You can also ask Siri to “Open ECG app” if you can’t find it quickly.

Proper Recording Position

Sit down and rest your arms on a table or your lap. Your watch should fit snugly but not too tight on your wrist.

Place your opposite hand’s finger gently on the Digital Crown. Don’t press down hard – just make gentle contact with the crown’s surface.

Common Position Mistakes

Many people press too hard on the crown or try to record while walking around. This creates electrical interference that ruins the reading.

Keep both arms still during the 30-second recording. Even small movements can make the sensors think your heart rhythm is irregular when it’s actually normal.

During the 30-Second Recording

The app shows a timer counting down from 30 seconds. You’ll see a live heart rhythm trace moving across the screen.

Try not to talk or move during this time. The sensors are picking up tiny electrical signals from your heart, and any movement can interfere.

Understanding Your EKG Results

After 30 seconds, your Apple Watch shows one of several possible results. Each one means something different about your heart rhythm.

Sinus Rhythm Result

This is the result you want to see most of the time. Sinus rhythm means your heart is beating in a regular, normal pattern.

The reading shows your heart rate was between 50-100 beats per minute with a consistent rhythm pattern.

Atrial Fibrillation Result

This result suggests your heart rhythm was irregular during the recording. Atrial fibrillation is a common heart rhythm disorder that affects millions of people.

If you get this result, especially multiple times, you should talk with your doctor. But don’t panic – many people with AFib live normal, active lives with proper treatment.

What AFib Actually Means

Research from the American Heart Association shows that AFib happens when the heart’s upper chambers beat irregularly. This can increase stroke risk over time if left untreated.

Your Apple Watch can’t diagnose AFib definitively. Only a doctor with a full medical EKG can do that. But the watch can spot patterns that deserve medical attention.

Inconclusive Results

Sometimes the app can’t get a clear reading. This happens more often than you might expect, and it’s usually not a problem.

Inconclusive results typically mean there was too much movement, poor contact with the crown, or your heart rate was outside the 50-150 range during recording.

When to Retry the Reading

Wait a few minutes and try again if you get an inconclusive result. Make sure you’re sitting still with good finger contact on the crown.

If you keep getting inconclusive results, check that your watch band isn’t too loose or tight. The sensors need consistent skin contact to work properly.

Storing and Sharing Your EKG Data

All your EKG recordings save automatically to the Health app on your iPhone. This creates a timeline you can review or share with doctors.

Viewing Past Recordings

Open the Health app and navigate to Heart > Electrocardiograms. You’ll see a list of all your recordings with dates and results.

Tap any recording to see the full waveform and details like heart rate and rhythm classification.

Exporting EKG PDFs

Each recording can export as a PDF that looks similar to medical EKGs. This makes it easy to share with healthcare providers.

Tap the share button on any recording and choose “Export a PDF for Your Doctor.” The PDF includes the waveform, your symptoms (if you added any), and the classification result.

Adding Symptom Notes

After each recording, you can add notes about how you felt. Options include things like “chest pain,” “dizziness,” or “felt fine.”

These notes help doctors understand the context around irregular readings. Even if your EKG looks normal, symptoms can provide important clues about heart health.

Best Practices for Accurate Readings

Getting consistent, accurate EKG readings takes a little practice. Here are the techniques that work best based on what I’ve learned from Apple’s guidelines.

Timing Your Readings

Take readings when you’re relaxed, not right after exercise or when you’re stressed. Your heart rate and rhythm change dramatically with activity and emotions.

Many cardiologists suggest taking readings at the same time each day if you’re monitoring a specific condition. This gives you more consistent baseline data.

Environmental Factors

Cold temperatures can affect your heart rate and the quality of readings. Try to record EKGs in comfortable room temperatures when possible.

Also avoid taking readings right after drinking caffeine or alcohol. Both substances can change your heart rhythm temporarily.

Skin Contact Tips

Clean, dry skin makes better contact with the sensors. If your hands are sweaty or oily, wipe them off before recording.

Very dry skin sometimes causes poor readings too. A tiny amount of hand lotion can help, but don’t use so much that your finger slips on the crown.

Troubleshooting Common Problems

Even with perfect technique, you might run into issues with EKG recordings. Most problems have simple solutions.

App Won’t Start Recording

If the ECG app opens but won’t begin a recording, check that your finger is making contact with the Digital Crown. The app needs to detect skin contact before starting.

Sometimes restarting the app helps. Force close it and reopen to reset the sensors.

Frequent Inconclusive Results

Multiple inconclusive readings usually point to movement or poor contact issues. Try sitting in a chair with armrests to keep your arms steady.

Your watch band might also be too loose. The back sensors need consistent wrist contact throughout the 30-second recording.

Heart Rate Too High or Low

The ECG app only works when your heart rate is between 50-150 beats per minute. Outside this range, you’ll get inconclusive results.

If your resting heart rate is naturally above or below this range, the Apple Watch EKG feature might not work well for you. A medical EKG doesn’t have these limitations.

Problem	Most Likely Cause	Quick Fix
Won’t start recording	No finger contact detected	Press finger firmly on crown
Inconclusive reading	Movement during recording	Sit still, arms supported
Heart rate out of range	Recent exercise or stress	Wait 10 minutes, try again
Poor waveform quality	Loose watch band	Tighten band slightly

Medical Limitations and When to See a Doctor

The Apple Watch ECG is a helpful screening tool, but it has real limitations. Understanding what it can and can’t do helps you use it appropriately.

What the ECG App Cannot Detect

According to FDA documentation, the Apple Watch cannot detect heart attacks, blood clots, strokes, or other serious cardiac events. It only looks for one specific rhythm pattern.

The single-lead reading also misses many types of arrhythmias that show up on medical 12-lead EKGs. It’s like looking at your heart through a keyhole instead of a window.

When to Contact Your Doctor

Get medical attention if you have multiple AFib readings, especially if you also have symptoms like chest pain, shortness of breath, or dizziness.

Also call your doctor if you have normal EKG readings but feel heart palpitations, racing heartbeat, or other concerning symptoms. The timing of symptoms might not match when you can take a reading.

Emergency Situations

Don’t rely on your Apple Watch during medical emergencies. If you have chest pain, severe shortness of breath, or think you’re having a heart attack, call 911 immediately.

The watch EKG takes 30 seconds and requires you to be still and conscious. During real cardiac emergencies, you need immediate professional help.

Conclusion

Recording an EKG on your Apple Watch is straightforward once you master the basic technique. Open the ECG app, place your finger on the Digital Crown, and stay still for 30 seconds. The key is finding a comfortable position where you can remain motionless during the recording.

Remember that this technology works best as a screening tool rather than a diagnostic device. While it can catch some irregular heart rhythms, it can’t replace regular checkups with your healthcare provider. Use your Apple Watch EKG readings as useful data to share with your doctor, but don’t rely on them alone for medical decisions about your heart health.

Can I take an EKG reading if my heart rate is over 150 BPM?

No, the Apple Watch ECG app only works when your heart rate is between 50-150 beats per minute. Readings outside this range will show as inconclusive, regardless of your actual heart rhythm.

How often should I record EKG readings on my Apple Watch?

For general health monitoring, taking an EKG a few times per week is plenty. If your doctor asks you to monitor a specific condition, they’ll give you guidance on frequency. Daily readings aren’t necessary unless you have symptoms or a diagnosed heart condition.

Do Apple Watch EKG readings work if I have a pacemaker?

The ECG app may not work reliably if you have a pacemaker or other implanted cardiac device. The electrical signals from these devices can interfere with the watch’s sensors. Consult your cardiologist about whether Apple Watch monitoring is appropriate for your situation.

Why do I keep getting inconclusive results even when sitting still?

Inconclusive results often happen due to dry skin, loose watch band, or electrical interference. Try moisturizing your hands lightly, adjusting your band tightness, or moving away from electronic devices. Cold hands can also cause poor readings.

Can the Apple Watch detect other heart problems besides atrial fibrillation?

The ECG app is only designed to detect atrial fibrillation patterns. It cannot identify heart attacks, heart failure, blocked arteries, or most other cardiac conditions. For comprehensive heart monitoring, you need medical testing beyond what any consumer device can provide.